June 2020
Revenue
Revenue by Region *
Net Patient Service Revenue (NPSR) per Adjusted Discharge was up year-over-year and to budget across all regions for the month. Hospitals in the Northeast/Mid-Atlantic saw the biggest increases, up 18% year-over-year and 13% above budget for this metric due to the large volume losses experienced.
All regions also were up year-over-year for NPSR per Adjusted Patient Day, but two regions fell below budget while three regions were at or above budget. Hospitals in the Midwest had the greatest year-over-year increase of 10%, while those in the Great Plains had the biggest increase to budget at 6%.
NPSR per Adjusted Discharge
NPSR per Adjusted Patient Day
IP/OP Adjustment Factor
Bad Debt And Charity
Bad Debt and Charity as a Percent of Gross was down year-over-year and compared to budget in the West, Great Plains, and South. The Northeast/Mid-Atlantic was essentially flat for this metric year-over-year, but fell 11% below budget, while the Midwest jumped 28% both year-over-year and to budget.
All regions saw declines year-over-year and compared to budget for the IP/OP Adjustment Factor. The Northeast/Mid-Atlantic and Midwest saw the greatest decreases, with both regions down about 14% year-over-year and 13% below budget.
National Revenue Observations
Most revenue metrics continued to fall below budget and below prior year performance for hospitals nationwide, but increased month-over-month. Total Gross Revenue was up 29% compared to April, but down 14% compared to May 2019 and 16% below budget.
Outpatient Revenue saw the largest increase, up 39% month-over-month, but down 27% year-over-year and 28% below budget. Inpatient Revenue rose 19% month-over-month, but fell 12% year-over-year and 17% below budget.
The Inpatient/Outpatient (IP/OP) Adjustment Factor decreased 9% compared to the same period last year and fell 8% below budget, but rose 8% compared to April, as outpatient volumes slowly began to recover. Bad Debt and Charity as a Percent of Gross rose just 2% year-over-year, but fell 1% month-over-month and 6% below budget expectations.
Budget Variance
Month Over Month
Year Over Year
Year Over Year Distributions
(Click to enlarge)
Total Gross Revenue
(16.3%)
29.3%
(14.0%)
total_gross_revenue.svg
IP Revenue
(16.6%)
18.9%
(11.9%)
ip_revenue.svg
OP Revenue
(28.1%)
39.2%
(27.0%)
op_revenue.svg
Bad Debt and Charity
(20.9%)
29.0%
(13.2%)
bad_debt_and_charity.svg
NPSR per Adjusted Discharge
5.2%
(0.1%)
9.6%
npsr_per_adj_discharge.svg
NPSR per Adjusted Patient Day
0.4%
(1.1%)
4.5%
npsr_per_adj_patient_day.svg
IP/OP Adjustment Factor
(7.5%)
8.3%
(9.1%)
ip_op_adjustment_factor.svg
Bad Debt and Charity as a % of Gross
(5.5%)
(0.8%)
2.4%
bad_debt_and_charity_percent.svg
Unless noted, figures are Actuals and Medians
Revenue by Bed Size
Looking at hospitals by size, five of six bed-size cohorts were up year-over-year and compared to budget for NPSR per Adjusted Discharge. Hospitals with 100-199 beds saw the biggest increases, up 14% year-over-year and 9% above budget. Smaller hospitals with 26-99 beds were an outlier, with NPSR per Adjusted Discharge up 7% year-over-year but falling 2% below budget.
NPSR per Adjusted Patient Day was up year-over-year across all six bed-size cohorts, but was below budget for three cohorts and above budget for the other three. The smallest hospitals of 0-25 beds had the biggest year-over-year increase of 6%, but was 3% below budget. Hospitals with 26-99 beds had the greatest variance to budget, falling 7% below budget, but up 3% year-over-year.
NPSR per Adjusted Discharge
NPSR per Adjusted Patient Day
IP/OP Adjustment Factor
Bad Debt And Charity
The IP/OP Adjustment Factor fell year-over-year and compared to budget across all bed-size cohorts. Hospitals with 100-199 and 200-299 beds saw the greatest year-over-year decreases of 11%. Hospitals with 200-299 beds also saw the greatest budget variance, at 9% below budget.
Bad Debt and Charity as a Percent of Gross rose year-over-year in five of six bed-size cohorts. The largest hospitals with 500 beds or more saw the greatest year-over-year increase at 13%, but also fell 13% below budget. Hospitals with 0-25 beds were the only cohort to see a year-over-year decrease at 30%, and fell 32% below budget.
©2020 Kaufman, Hall & Associates, LLC
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